Abscess

Cause

An abscess can arise after tissue has been infected by a bacterium, a parasite or a substance foreign to the body. In a situation like that, the body sends white blood cells to the infected area to clean up everything. If the immune system, however, can't win the battle against the harmful invaders, an abscess may arise. The bacteria destroy a large number of cells in short time then, causing necrosis. This creates a swelling filled with pus, which contains living and dead bacteria or foreign substances, white blood cells and tissue debris. The growing swelling leads to pressure under the skin and further inflammation of surrounding tissue. The pressure and inflammation cause pain. Abscesses can also be caused by chronic inflammatory diseases, such as Crohn's disease. As long as an abscess is closed, the bacteria cannot go out and the condition is not contagious.

Symptoms

There are superficial and internal abscesses, depending on where they occur. In a superficial abscess, bacteria penetrate the skin or subcutaneous tissue. An internal abscess can be located anywhere in the wall of an organ or inside the organ, for example in the wall of the intestine. Notorious is the inflammation of the appendix, which may turn into an abscess. Apart from superficial and internal abscesses, we can also distinguish warm and cold abscesses. A warm abscess is a subcutaneous accumulation of pus which is usually surrounded by a red-colored area. Warm abscesses are fairly common, for example on the gums and in the throat. A cold abscess has a blue-red color and is caused by tubercolosis. This type of abscess is rare.
An abscess usually causes the following signs and symptoms:

• Swelling, pain and heat in the affected area.
• The area around the abscess is usually red in color.
• Fever.
• Nausea.
• Sweating.
• Malaise, feeling ill.

Diagnosis

An abscess may be detected by doing a physical examination. Sometimes pus is taken away for a culture, in order to see which organisms cause the infection and which antibiotics can best be used.

Treatment

An abscess can break spontaneously. When this occurs, the pus flows off via a hollow organ (intestines, lungs, etc.) or through the skin, as happens with an inflamed finger. In some cases, antibiotics are given. In case of superficial abscesses, the doctor often prefers to choose the method of discharge by himself and cuts the abscess in order to stop the expansion of necrosis and to speed up healing. After a puncture or incision, the toxic abscess mass no longer presses into the surrounding healthy tissue and drains off. Usually the symptoms, such as fever, disappear immediately. In some cases, the doctor decides to build a drain until the abscess cavity is clean. The clean wound edges eventually grow together, leaving a scar of connective tissue.

Prognosis

Early treatment of small abscesses usually results in effective healing. Most abscesses heal in ten to fourteen days after incision and drainage. In case of larger, deep abscesses, the outcome depends on the location of the abscess, the age and health condition of the patient and the timing and effectiveness of the treatment. An abscess in a vital organ may result in a permanent functional decline.

Considerations

• Don’t break the abscess yourself, because this worsens the problem. Any bacteria contained in the abscess, can spread then.
• Obtaining an abscess can't always be prevented. However, proper personal hygiene can ensure getting fewer infections. Make sure the skin is clean and remains clean, by regularly washing with soap and water.
• Apply hot compresses to small abscesses (less than a centimeter in diameter).
• Beware of cuts when shaving forearms or pubic area.

Facts

• The term ‘abscess’ is derived from the Latin word abscessus (retreat).
• Abscesses are common, but the exact prevalence is unknown.